三维斑点追踪技术评价高血压患者左心室扭转的临床研究

摘要

Objective To observe features of twist of the left ventricle (LV) in patients of essential hypertension (EH) with LV normal geometry (LVN) by three-dimensional speckle tracking imaging (3D-STI).Methods Thirty EH patients with LVN and 32 healthy control subjects were included.From the dynamic images of LV apical two-and four-chamber-views and three-dimensional full volume dataset acquired,the following parameters were obtained:peak of LV basal,middle and apical segment rotation (Prot-B,Prot-M and Prot-A),peak of LV global segment twist (LV-tw) and rotation (LV-rot),the global radial and longitudinal displacement (Dr,Dl) and the global 3D displacement (D3d).The difference of these parameters was compared between EH and control groups,and the correlation between LV-tw and the displacements in EH group was studied.Results Compared with the normal control group,Prot-B,Prot-M,Prot-A,LV-tw,LV-rot,Dr,Dl and D3d of EH group were significantly increased (P ＜ 0.01 or 0.05),and LV-tw showed significant correlation with Dr,Dl and D3d (P ＜0.01 or 0.05).Conclusions The evaluation of LV twist with 3DSTI in EH patients can reflect the changes of LV systolic function in early stage,3D-STI may provide a new modality for quantitative evaluation of early abnormality of LV function in clinical practice.%目的 应用三维斑点追踪成像技术(3D-STI)定量评价正常构型原发性高血压患者左心室扭转运动.方法 左室几何构型正常的原发性高血压患者30例,正常对照组32例,经胸采集心尖四腔和两腔观图像以及左室三维全容积数据,获取左室基底段、中间段和心尖段旋转角度峰值(Prot-B、Prot-M、Prot A)、左室整体旋转角度峰值(LV-rot)和扭转角度峰值(LV-tw)、左室整体最大径向位移(Dr)、纵向位移(Dl)和三维位移(D3d)等参数,比较高血压组和正常对照组间各参数的差异,并分析左室扭转角度峰值和位移参数的相关性.结果 与对照组比较,高血压组旋转和扭转参数Prot-B、Prot-M、Prot-A、LV-rot、LV-tw以及位移参数Dr、Dl和D3d均显著增加(P＜0.01或0.05),LV-tw与Dr、Dl、D3d间存在良好相关性.结论 应用3D-STI评价左室扭转运动能够反映几何构型正常的高血压患者左室收缩功能的改变,有望为临床早期定量评价左室功能异常提供一种新方法.